AB1228 MEDICAL CARE CONSUMPTION BY TUNISIAN DOCTORS SUFFERING FROM LOW BACK PAIN
Authors: A. Fazaa, H. Boussaa, S. Miladi, K. Ouenniche, L. Souabni, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2022)

Background Common low back pain (LBP) is a real public health problem. Indeed, LBP is associated with important socio-professional consequences and involves a raised cost for society due to absenteeism and medical consumption. Various studies show that it is also a major problem in workplace especially in hospitals. Objectives The aim of this study was to evaluate LBP medical consequences among doctors. Methods We performed a cross-sectional study including the medical staff of a Tunisian hospital. A standardized questionnaire was distributed to all departments and collected the following day. Doctors who had not responded to the questionnaire received two reminders before considering their exclusion. We defined two groups: Group 1 with acute LBP (&lt;3 months) and Group 2 with chronic LBP (≥3 months). The following parameters were collected: consultation with a physician, self-medication, treatments used, hospitalization, use of imaging methods and objectified spinal abnormalities. A p value inferior to 0.05 was considered statistically significant. Results Of the 217 questionnaires distributed to physicians, 107 (49.3%) were completed. The participants were composed of 85 women and 22 men. The mean age was 31.8 ± 7.7 years [25-57]. The mean BMI was 23.2±3.7 kg/m 2 [16.6-36.7]. Consumption of tobacco and alcohol was noted in 16.7% and 20.4% of cases respectively. Five participants (4.6%) reported consumption of cannabinoids. Depression, anxiety and sleep disturbances were reported in 25.3%, 57.3% and 46.7% of cases respectively. Among the participants, 84.3% reported having had LBP at least once in their life, and 71.3% reported LBP in the past 12 months. The mean duration of low back pain was greater than 3 months in 11.9% of cases. The mean pain intensity was 4.4 ± 1.9 [2-10]. Twenty participants (26%) consulted a doctor. It was a rheumatologist in 13 cases, an orthopedist in 7 cases, a neurosurgeon in 1 case and a family doctor in 1 case. More than half of the participants (57.5%) self-medicated. Standard radiography was performed in 18 cases, computed tomography (CT) in 5 cases and magnetic resonance imaging (MRI) in 8 cases. The following abnormalities were objectified: degenerative disc disease (13.6%), herniated disc (22.7%) and posterior inter-apophyseal osteoarthritis (9%). Medication use was noted in 56 cases (72.7%), functional rehabilitation in 9 cases (11.7%), back support belt in 3 cases (3.9%), epidural corticosteroid injection in 1 case (1.3%), thermal treatment in 1 case (1.3%), and surgery in 1 case (1.3%). Three doctors required hospitalization ranging from 2 to 15 days. Medical care consumption was significantly more important in patients with chronic LBP: functional rehabilitation (6,8% in group 1 vs 50% in group 2, p&lt;0.001), back support belt (1,6% vs 20%, p=0.046), epidural corticosteroid injection (0% vs 10%, p=0.035), thermal treatment (0% vs 10%, p=0.035), surgery (0% vs 10%, p=0.035) and hospitalization (0% vs 30%, p&lt;0.001). Conclusion Medical care consumption was important among LBP and chronic LBP sufferers. Thus, a prevention strategy must be established in hospitals in order to reduce the socio-economic cost of LBP among caregivers. Disclosure of Interests None declared